慢性胃炎胃脘痛证型与胃镜黏膜表现相关性Logistic回归分析

目的:分析慢性胃炎胃脘痛证型与胃镜下黏膜表现的相关性。方法:使用χ2检验和多项Logistic回归分析,分析273例以胃脘痛为主要症状的慢性胃炎患者证型、镜下黏膜表现分布及其相关性。结果:肝胃不和证与黏膜红肿或红斑(OR=2.201E-009,P=0.000)、胆汁反流或黏液湖色黄(OR=59.035,P=0.041)相关;脾胃虚弱(寒)证与黏膜苍白或红白相间(OR=18.862,P=0.040)、黏膜粗糙(OR=32.091,P=0.039)、黏膜出血点(OR=5.024E-009,P=0.000)相关;胃阴不足证与黏液湖量少(OR=38.541,P=0.049)相关;胃络瘀阻证与黏膜出血点(因变量参考组)相关;脾胃湿热证未得到有意义结果。结论:胃镜黏膜视诊引入到胃脘痛中医诊断望诊是一条有效途径,但仍需扩大样本数量,纳入复杂交互因素,完善Logit模型,所以现阶段以胃脘痛为主要表现的慢性胃炎胃镜下黏膜表现可作为胃脘痛辨证的充分条件但不是必要条件,作为望诊的补充。

Logistic Regression Analysis on Relationship between Chinese Medical Syndrome Typing and Gastroscopic Mucosa Manifestation in Epigastric Pain of Chronic Gastritis

Objective:To analyze the relationship between syndrome and gastroscopic mucosa manifestations of epigastric pain of chronic gastritis. Methods:Chi-square test and multiple Logistic regression analysis were used to analyze the distribution and correlation of syndrome and gastroscopic mucosa manifestations in total 273 patients with chronic gastritis,epigastric pain as the main symptom. Results:Liver-stomach disharmony syndrome was associated with mucosal redness or erythema(OR= 2.201 E-009,P= 0.000),bile reflux or mucus lake yellow(OR= 59.035,P= 0.041);Spleen and stomach deficiency(cold) syndrome was associated with pale or red and white mucosa(OR= 18.862,P= 0.040),rough mucosa(OR= 32.091,P= 0.039),mucosal bleeding point(OR= 5.024 E-009,P= 0.000);Stomach yin deficiency was associated with less mucus lake(OR= 38.541,P= 0.049);Stasis in stomach collateral syndrome was associated with mucosal bleeding point(dependent variable reference group);Spleen-stomach damp-heat syndrome did not get meaningful results. Conclusions:It is an effective way to introduce the gastroscopic mucosal visual examination into the traditional Chinese diagnosis of epigastric pain. However,it is still necessary to expand the sample size,incorporate complex interaction factors,and improve the Logit model. Therefore,at this stage,the gastroscopic mucosa manifestation as the supplement to the traditional Chinese diagnostic method was a sufficient but not the necessary condition for the epigastric pain of chronic gastritis.